Monitoring surface contamination for thirty antineoplastic drugs: a new proposal for surface exposure levels (SELs)

• Authors: Stefano Dugheri , Nicola Mucci , Elisabetta Bucaletti , Donato Squillaci , Giovanni Cappelli , Lucia Trevisani , Alessandro Bonari , Michele Cecchi , Enrico Mini , Andrea Ghiori , Daniela Tognoni , Nicola Berti , Francesca Alderighi , Nicola Li Vigni , Irene Orlandi , Giulio Arcangeli

Abstracts

EN

Background Chemotherapy drugs are widely used to treat cancer, but their active compounds represent a danger for workers who could be exposed to them. However, they aren’t yet included in directive CE No. 1272/2008 and the European Biosafety Network has only recommended a limit value of 100 pg/cm² for surface contamination. Thus, it is crucial to assess surface contaminations in healthcare environments. Currently, the technique of choice is surface wipe test combined with liquid chromatography tandem mass spectrometry to achieve high sensibility. Material and Methods A campaign involving Careggi University Hospital (Florence, Italy) was performed from January 2020 to December 2021, collecting 1449 wipe samples between administration units, preparation unit, and personnel gloves. From the obtained data, the 90th percentile was calculated for 30 antiblastic drugs and proposed as surface exposure levels (SELs); while from data concerning personnel glove contamination, weekly contamination was estimated. Results In the 2-year period only 417 wipe samples were found positive (28.8%), the majority of which regard samples coming from administration unit bathrooms. The proposed SELs are almost all <100 pg/cm², except for few drugs which produce higher contamination on bathroom surfaces. Also, the estimation of pharmacy personnel’s glove contamination highlighted very low results (ng/week). Conclusions Deeply established protocols and procedures for safe handling of ADs allow for obtaining excellent cleaning results and thus a safer work environment, however, the risk of cytostatic contaminations cannot be avoided in healthcare workplaces, and thus a harmonization of classification and labeling of chemotherapy drugs throughout the European Union should be done.

Keywords

EN

health risk assessment; antineoplastic drugs; wipe test; ultra-high performance liquid chromatography; surface exposure level; tandem mass spectrometry

• Publisher: Instytut Medycyny Pracy im. prof. dra Jerzego Nofera w Łodzi
• Journal: Medycyna Pracy
• Year: 2022
• Volume: 73
• Issue: 5
• Pages: 383-396

Dates

published

2022

Contributors

author

Stefano Dugheri

• Careggi University Hospital, Florence, Italy (Industrial Hygiene and Toxicology Laboratory, Occupational Medicine Unit)

author

Nicola Mucci

• University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)

author

Elisabetta Bucaletti

• University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)

author

Donato Squillaci

• University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)

author

Giovanni Cappelli

• University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)

author

Lucia Trevisani

• University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)

author

Alessandro Bonari

• Careggi University Hospital, Florence, Italy (General Laboratory)

author

Michele Cecchi

• Careggi University Hospital, Florence, Italy (Pharmacy AD Preparation Unit)

author

Enrico Mini

• University of Florence, Florence, Italy (Department of Health Sciences)

author

Andrea Ghiori

• Careggi University Hospital, Florence, Italy (Pharmacy AD Preparation Unit)

author

Daniela Tognoni

• Careggi University Hospital, Florence, Italy (Pharmacy AD Preparation Unit)

author

Nicola Berti

• Careggi University Hospital, Florence, Italy (Health and Safety Service)

author

Francesca Alderighi

• Careggi University Hospital, Florence, Italy (Health and Safety Service)

author

Nicola Li Vigni

• Careggi University Hospital, Florence, Italy (Health and Safety Service)

author

Irene Orlandi

• Careggi University Hospital, Florence, Italy (Health and Safety Service)

author

Giulio Arcangeli

• University of Florence, Florence, Italy (Department of Experimental and Clinical Medicine)

Identifiers

DOI

10.13075/mp.5893.01288

Biblioteka Nauki

2152946